Optic canal decompression: Crucial goal in SOM surgery for improved visual outcomes - A case series

Background. Sphenoorbital meningioma (SOM) often presents with proptosis and vision impairment due to optic nerve compression within the optic canal, primarily caused by hyperostosis. This study aims to highlight the importance of optic canal decompression during SOM surgery. Fourteen patients with SOM and vision impairment underwent surgery focused on adequate optic canal decompression. Vision was evaluated preoperatively, at three months, and at six months postoperatively. Preoperative vision loss was confirmed to be due to optic nerve compression by surrounding hyperostotic bone. Six-month postoperative evaluations showed significant improvement in visual acuity in twelve of the fourteen patients. SOM frequently occurs in women in their 50s. Early surgical intervention is crucial for patients with visual symptoms to achieve better outcomes. While cosmetic correction of proptosis is important, the primary surgical goal should be decompression of the optic nerve.